Doctors blame vaccination neglect as measles makes a comeback

By Thuy Vi, TN News

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A baby is being treated at a Ho Chi Minh City hospital for measles. Photo by Luong Ngoc  
More kids are getting measles across Vietnam as doctors blame low vaccination rates due to fears caused by recent infant fatalities allegedly linked to a popular vaccine.
Nguyen Tran Hien, chairman of the National Extended Vaccination Program, said the country has reported hundreds of measles infections, mostly in Hanoi and the northern mountainous provinces of Son La, Yen Bai, Lao Cai, as well as Ho Chi Minh City in the southern region.
A 7-month-old baby from Hanoi’s Dong Anh District died during the Tet (Lunar New Year) festival early this month while two other children died in Yen Bai. This is the first time in three years that Hanoi has reported measles outbreak.

The disease has occurred mostly in children that have not been vaccinated fully, or at all.

“When we have enough unprotected children, there’s an outbreak,” Hien told Tuoi Tre newspaper. “And there will continue to be small ones in provinces in the coming time.”

Dr. Nguyen Van Lam from the Central Pediatrics Hospital in Hanoi said his facility has also received patients from other northern provinces that have not announced outbreaks like Phu Tho, Vinh Phuc, Nam Dinh, Hai Duong, Bac Ninh and Ninh Binh.

Children in Vietnam are given their first measles shot at nine months old and the second at 18 months. The final shot increases the protection chance to 99 percent from 85 percent after the first shot, doctors said.

A report from the vaccination program showed that the disease started to appear in northern highlands provinces last April and began spreading strongly from late January.

It said the highlands provinces have communication and terrain problems that hinder proper vaccination.

Parents in the cities and the lowlands have meanwhile said that they have been discouraged by the fatal scandals linked to popular 5-in-1 vaccine Quinvaxem and are keeping their children away from most vaccines including measles.

Quinvaxem is given to babies in three stages starting when they are two months old to protect them from diphtheria, tetanus, pertussis (whooping cough), hepatitis B, and Haemophilus influenzae type B, but three babies have died after receiving it since the liquid was reintroduced in Vietnam last October, after a temporary ban in May following the deaths of nine infants since November 2012.

Surveys found that 40 percent of measles patients in Hanoi
were not vaccinated, compared to 84 percent of those in the southern region including Ho Chi Minh City. Some unvaccinated children from the city are of migrant laborer parents who move often.

Dr. Phan Trong Lan, head of Ho Chi Minh City Pasteur Institute, warned that the number of measles cases in southern Vietnam is going to surge from previous years as the number of children receiving vaccination, especially their second and final shots, has dropped.

The institute has chronicled 130 infections in the region, including 84 in the city.

The Ho Chi Minh City Hospital of Tropical Diseases admitted 48 cases during the last two months of 2013 and 72 more cases, including 59 from the city, since early this year, compared to 14 cases in 2011 and 2012. Around 90 percent of the patients are under 3 years old.

The number of cases from the southern hub has not reached the high of six years ago, but the patients have developed more serious complications and several children were put on respirators.

Some children were infected after fully vaccinated.

Dr. Nguyen Ngoc Vinh from the hospital, which has received several such cases, said there could be problems with the vaccine quality or the administering process.

Lan told Tuoi Tre that the vaccination rate in Ho Chi Minh City during November and December dropped to half compared to the same period in previous years.
Only 37 percent of children received the second shot, according to Lan.

The doctor called that a gap in community immunity. “The gap is getting bigger, and that, combined with convenient travel, will cause widespread outbreaks as measles itself is easily transmitted.”

Vietnam used to have tens of thousands of measles infections a year, but the number has come down to very few thanks to vaccinations, Lan said.
“If it is neglected, the disease will come back.”

A recent statement from the Health Ministry’s Preventive Health Department said it will organize national checks and make sure all children below 2 years old are vaccinated.

HCMC Preventive Health Department said it will provide free shots for unvaccinated children from 9 months to 3 years old.

Immediate protection is to stay away from infected person for at least two weeks and until several days after they are healthy again, keeping a distance of at least 1.5 meters, he said.

Measles is not malignant but it quickly destroys one’s immune system and thus causes children to be infected with other dangerous diseases such as pneumonia or diarrhea that can lead to fatal developments, doctors said.

Patients that easily develop complications from the disease include the malnourished, those below 5 years old and people with poor immune systems.
Vietnam plans to erase the disease by 2017.

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